scholarly journals Increasing transplantability in Brazil: time to discuss Kidney Paired Donation

2021 ◽  
Author(s):  
Juliana Bastos ◽  
David José de Barros Machado ◽  
Elias David-Neto
Keyword(s):  
Chronic Kidney Disease ◽  
Deceased Donor ◽  
Developed Countries ◽  
Promising Alternative ◽  
Transplant Program ◽  
Kidney Paired Donation ◽  
Allocation Criteria ◽  
The Usa ◽  
Different Dimensions ◽  
Low Probability

Abstract Introduction: Kidney transplantation (KT) is the best treatment for chronic kidney disease. In Brazil, there are currently more than 26 thousand patients on the waitlist. Kidney Paired Donation (KPD) offers an incompatible donor-recipient pair the possibility to exchange with another pair in the same situation, it is a strategy to raise the number of KT. Discussion: KPD ceased being merely an idea over 20 years ago. It currently accounts for 16.2% of living donors KT (LDKT) in the USA and 8% in Europe. The results are similar to other LDKT. It is a promising alternative especially for highly sensitized recipients, who tend to accumulate on the waitlist. KPD is not limited to developed countries, as excellent results were already published in India in 2014. In Guatemala, the first LDKT through KPD was performed in 2011. However, the practice remains limited to isolated cases in Latin America. Conclusion: KPD programs with different dimensions, acceptance rules and allocation criteria are being developed and expanded worldwide to meet the demands of patients. The rise in transplantability brought about by KPD mostly meets the needs of highly sensitized patients. The Brazilian transplant program is mature enough to accept the challenge of starting its KPD program, intended primarily to benefit patients who have a low probability of receiving a transplant from a deceased donor.

Pain-Prescription Differences - An Analysis of 500,000 Discharge Summaries

2019 ◽  
Vol 11 (1) ◽  
pp. 58-66 ◽  
Author(s):  
Saskia Preissner ◽  
Vishal B. Siramshetty ◽  
Mathias Dunkel ◽  
Paul Steinborn ◽  
Friedrich C. Luft ◽  
...  
Keyword(s):  
Pain Therapy ◽  
Opioid Analgesic ◽  
Developed Countries ◽  
Discharge Summary ◽  
Pain Reliever ◽  
Regulatory Guidelines ◽  
The Usa ◽  
Prescription Rates ◽  
East West ◽  
Discharge Summaries

Background: Pain-relief prescriptions have led to an alarming increase in drug-related abuse. Objective: In this study, we estimate the pain reliever prescription rates at a major German academic hospital center and compare with the nationwide trends from Germany and prescription reports from the USA. Methods: We analysed >500,000 discharge summaries from Charité, encompassing the years 2006 to 2015, and extracted the medications and diagnoses from each discharge summary. Prescription reports from the USA and Germany were collected and compared with the trends at Charité to identify the frequently prescribed pain relievers and their world-wide utilization trends. The average costs of pain therapy were also calculated and compared between the three regions. Results: Metamizole (dipyrone), a non-opioid analgesic, was the most commonly prescribed pain reliever at Charité (59%) and in Germany (23%) while oxycodone (29%), a semi-synthetic opioid, was most commonly ordered in the USA. Surprisingly, metamizole was prescribed to nearly 20% of all patients at Charité, a drug that has been banned for safety reasons (agranulocytosis) in most developed countries including Canada, United Kingdom, and USA. A large number of prospective cases with high risk for agranulocytosis and other side effects were found. The average cost of pain therapy greatly varied between the USA (125.3 EUR) and Charité (17.2 EUR). Conclusion: The choice of pain relievers varies regionally and is often in disagreement with approved indications and regulatory guidelines. A pronounced East-West gradient was observed with metamizole use and the opposite with prescription opioids.

scholarly journals Inequalities in the Global Burden of Chronic Kidney Disease Due to Type 2 Diabetes Mellitus: An Analysis of Trends from 1990 to 2019

2021 ◽  
Vol 18 (9) ◽  
pp. 4723
Author(s):  
Nóra Kovács ◽  
Attila Nagy ◽  
Viktor Dombrádi ◽  
Klára Bíró
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Data Exchange ◽  
Disease Burden ◽  
Socioeconomic Development ◽  
Developed Countries

The prevalence of type 2 diabetes mellitus (T2DM) and the burden of complications are increasing worldwide. Chronic kidney disease (CKD) is one serious complication. Our aim was to investigate the trends and inequalities of the burden of CKD due to T2DM between 1990 and 2019. Data were obtained from the Global Health Data Exchange database. Age-standardized incidence, mortality, and DALYs rates of CKD were used to estimate the disease burden across the Human Development Index (HDI). Joinpoint regression was performed to assess changes in trend, and the Gini coefficient was used to assess health inequality. A higher incidence was observed in more developed countries (p < 0.001), while higher mortality and DALYs rates were experienced in low and middle HDI countries in 2019 (p < 0.001). The trend of incidence has increased since 1990 (AAPC: 0.9–1.5%), while slight decrease was observed in low HDI countries in mortality (APC: −0.1%) and DALYs (APC: −0.2%). The Gini coefficients of CKD incidence decreased from 0.25 in 2006 to 0.23 in 2019. The socioeconomic development was associated with disease burden. Our findings indicate that awareness of complications should be improved in countries with high incidence, and cost-effective preventive, diagnostic, and therapeutic tools are necessary to implement in less developed regions.

What Should We Know About the Origins of International Investment Law?

2020 ◽  
Vol 48 (3) ◽  
pp. 122-131
Author(s):  
Sarah M. Alshahrani
Keyword(s):  
Ottoman Empire ◽  
Historical Context ◽  
Developed Countries ◽  
International Investment ◽  
Arab Countries ◽  
International Investment Law ◽  
The Usa ◽  
Investment Law ◽  
Investment Treaties ◽  
The Impact

AbstractInternational investment law, particularly the global backlash against investment treaties, has evolved recently. This article aims to clarify how international investment law evolved over history, from the early Arab traders in the 7th century to the Ottoman Empire, to understand its hidden aims. It investigates the practice of signing investment treaties, which appear first during the Fatimid Caliphate2 and Mamluk Sultanate3 periods. It then explains when control over foreign investment started to diminish during the Ottoman Empire period.4 Further, it explains the links between the USA Friendship, Commerce and Navigation treaties (FCNs), and current investment treaties, explaining the impact of colonization and imperialism on drafting treaty provisions. Within this historical context, this article illustrates the need to understand the roots of international investment law in order to urge Arab countries to terminate or renegotiate current bilateral investment treaties (BITs) as a number of developing and developed countries have done.

scholarly journals Tuberculosis presenting as dacryoadenitis in the USA

2019 ◽  
Vol 12 (11) ◽  
pp. e231694 ◽  
Author(s):  
Harry Ross Powers ◽  
Mark Anthony Diaz ◽  
Julio C Mendez
Keyword(s):  
Correct Diagnosis ◽  
Developed Countries ◽  
Histopathological Analysis ◽  
Orbital Mass ◽  
Antituberculosis Therapy ◽  
The Usa ◽  
History Of ◽  
Patient’S History ◽  
High Degree ◽  
Filipino Woman

A 25-year-old Filipino woman living in the USA was evaluated for a 5-month history of left eye pain and a subsequent orbital mass. Histopathological analysis of the lacrimal mass showed a mixed inflammatory process with necrotising granulomas and positive cultures for Mycobacterium tuberculosis. She was treated with antituberculosis therapy, with resolution of symptoms. Tuberculosis dacryoadenitis is extremely rare in the USA and other developed countries. It requires a high degree of clinical suspicion with special attention to the patient’s history to make the correct diagnosis. It can be treated successfully with antituberculosis therapy.

Macroeconomic conditions are only an illusion, not the solution, to firm sustainability: unveiling the new dimension of stakeholder well-being

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Zahid Irshad Younas ◽  
Mahvesh Khan ◽  
Mamdouh Abdulaziz Saleh Al-Faryan
Keyword(s):  
Well Being ◽  
Developed Countries ◽  
Macroeconomic Performance ◽  
Content Type ◽  
Macroeconomic Conditions ◽  
Us Economy ◽  
The Us ◽  
The Usa ◽  
Negative Impacts ◽  
The One

Purpose The purpose of the study is to explore the misconception that in developed countries, macroeconomic performance lead to sustainable firms or improves stakeholder well-being. The results may be the opposite or even worse. Design/methodology/approach This study examined this misconception using balanced panel data from 1,122 firms from different sectors of the US economy and data on macroeconomic performance from the World Bank. Findings The results of the one-step generalised method of moments indicate that most macroeconomic performance indicators had significant and negative impacts on firm sustainability and stakeholder well-being. Practical implications From a societal perspective, the results illustrate that the fruits of macroeconomic performance of the US economy do not reach stakeholders through firms’ sustainability. Thus, linking the economy’s macroeconomic performance with firm sustainability is vital for sustainably uplifting society and for stakeholder well-being. Originality/value From a policy perspective, this study reveals that the greater focus on macroeconomic performance in the USA over the past decades has resulted in lower firm sustainability because of the malfunctioning of social, economic, environmental and governance factors. This has negatively influenced stakeholder well-being in the country.

Criteria for the Evaluation of Social Policy Effectiveness of States

2014 ◽  
pp. 87-97
Author(s):  
V. Sautkina
Keyword(s):  
Developed Countries ◽  
Legal Aspects ◽  
Educational Services ◽  
State Control ◽  
National Education ◽  
Current State ◽  
The Usa ◽  
The Government ◽  
High Level ◽  
The Cost

The following article is devoted to the study of current state of national education and healthcare systems. The cost of services in these areas constantly increases, there for even developed countries are forced to make significant efforts in order to maintain earlier achieved results. Due to this reason countries entered into the period of constant reforms with the purpose of maintaining that high level of health and educational services for all segments of population with a constant reduction of its volume of financing. The legal aspects of these changes are requiring manifestation of the will of politicians in order to overcome the opposition of parties which are defending their interests. As an example, the main opponents of the healthcare reforms proposed by Barak Obama in the USA are Republicans who are concerned about a significant increase of a state control over the entire national insurance system. The author comes to the conclusion that only joint actions of the government and every segment of population might actually improve the quality of medical and educational services.

scholarly journals Infectious diseases acquired by international travellers visiting the USA†

2018 ◽  
Vol 25 (1) ◽  
Author(s):  
Rhett J Stoney ◽  
Douglas H Esposito ◽  
Phyllis Kozarsky ◽  
Davidson H Hamer ◽  
Martin P Grobusch ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Descriptive Analysis ◽  
Low Frequency ◽  
Developed Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
International Tourist ◽  
Clinical Diagnoses ◽  
The Usa ◽  
Systemic Infections

Abstract Background Estimates of travel-related illness have focused predominantly on populations from highly developed countries visiting low- or middle-income countries, yet travel to and within high-income countries is very frequent. Despite being a top international tourist destination, few sources describe the spectrum of infectious diseases acquired among travellers to the USA. Methods We performed a descriptive analysis summarizing demographic and travel characteristics, and clinical diagnoses among non-US-resident international travellers seen during or after travel to the USA at a GeoSentinel clinic from 1 January 1997 through 31 December 2016. Results There were 1222 ill non-US-resident travellers with 1393 diagnoses recorded during the 20-year analysis period. Median age was 40 (range 0–86 years); 52% were female. Patients visited from 63 countries and territories, most commonly Canada (31%), Germany (14%), France (9%) and Japan (7%). Travellers presented with a range of illnesses; skin and soft tissue infections of unspecified aetiology were the most frequently reported during travel (29 diagnoses, 14% of during-travel diagnoses); arthropod bite/sting was the most frequently reported after travel (173 diagnoses, 15% after-travel diagnoses). Lyme disease was the most frequently reported arthropod-borne disease after travel (42, 4%). Nonspecific respiratory, gastrointestinal and systemic infections were also among the most frequently reported diagnoses overall. Low-frequency illnesses (&lt;2% of cases) made up over half of diagnoses during travel and 41% of diagnoses after travel, including 13 cases of coccidioidomycosis and mosquito-borne infections like West Nile, dengue and Zika virus diseases. Conclusions International travellers to the USA acquired a diverse array of mostly cosmopolitan infectious diseases, including nonspecific respiratory, gastrointestinal, dermatologic and systemic infections comparable to what has been reported among travellers to low- and middle-income countries. Clinicians should consider the specific health risks when preparing visitors to the USA and when evaluating and treating those who become ill.

scholarly journals LOBBYING IN THE SYSTEM OF SOCIO-ECONOMIC PRIORITIES OF UKRAINE

2020 ◽  
pp. 53-69
Author(s):  
Olena GOLOVNYA
Keyword(s):  
Regional Integration ◽  
Trade Unions ◽  
High Sensitivity ◽  
Developed Countries ◽  
Civil Society Organizations ◽  
Modern World ◽  
Business And Society ◽  
Electoral Campaigns ◽  
The Usa ◽  
The Government

The article is devoted to the research of lobbying activities as an important component of the process of forming the state policy of socio-economic development. The author emphasizes that the Ukrainian economy has a high dependence on the external environment, as well as high sensitivity to global economic fluctuations. In turn, the openness of the country's economy is a significant factor in its involvement in modern value chains, global and regional integration. It is determined that securing a full-fledged public-private partnership in the modern world requires lobbying as a deliberate influence on the public by the authorities in order to make a number of economic decisions. The study found that the structure of the phenomenon of "lobbying" includes three main components: object, subject, technology. Thus, lobbying in the modern world appears to be a complex process of purposeful influence on the government in order to obtain the desired solution. The purpose of lobbying structures activities is often a series of decisions, in which the adoption of laws concerning economic activity and investment, innovation, and customs policies is of great importance. It is revealed that lobbying requires an extensive network of institutions and organizations - from trade unions and business owners to the media and civil society organizations. Significant influence on the advancement of national socio-economic priorities is exercised by consulting firms, mass media, non-state think tanks, various industry associations. Lobbying in developed countries is a tool for cooperation and communication that leads to progressive decisions that are beneficial to both business and society. This confirms the progressive experience of the USA and the EU. The study draws attention to the fact that Ukraine mainly practices shadow lobbying, since the activities of domestic lobbyists are not regulated by any legislative acts. This is explained by the fact that our business and political leaders benefit from such interaction when large financial and industry groups sponsor, large decision-makers and expensive electoral campaigns.

scholarly journals Technological Progress, Globalization, and Secular Stagnation

2018 ◽  
Vol 7 (1) ◽  
pp. 59-100 ◽  
Author(s):  
Milenko Popović
Keyword(s):  
World Economy ◽  
Aggregate Demand ◽  
Careful Analysis ◽  
Developed Countries ◽  
Supply Side ◽  
Critical Survey ◽  
Technological Advancement ◽  
Secular Stagnation ◽  
Dual Economy ◽  
The Usa

AbstractAfter the 2008 crisis, despite economic recovery that started in 2009, the world economy has experienced a downward shift of its growth path and a consequent decline. As shown at the beginning of this paper, this shift and growth rate stagnation are totally attributable to the economic dynamics in developed economies, the USA and the EU. Explanations of this phenomenon can be divided into two large groups: explanations that belong to the demand side and those that belong to the supply side. The aim of this paper is to give a critical survey of the most important explanations for the ongoing growth stagnation in developed countries and consequently in the entire world economy. This ongoing prolonged stagnation can only be explained by looking at both, the demand and supply sides of the explanation, and particularly by taking a closer look at the interaction between aggregate demand and aggregate supply. In other words, secular stagnation manifests itself as a problem of the limitation of long run growth of aggregate demand. However, in order to explain the causes of those demand limitations, we have to undertake a careful analysis of the supply side dynamics, especially the dynamics of innovations, which bring us to circular and cumulative causation. In order to explain the numerous consequences of this stagnation and to solve some important puzzles, like the productivity paradox for example, a special emphasis is given to the analysis of deindustrialization and the consequent strange reoccurrence of a dual economy within most developed countries during the period of the IT revolution and hyper-globalization. It will also be shown that this new dual economy presents serious limitations for further technological advancement and economic development, quite contrary to the old dualism which contributed to an acceleration of economic growth.

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